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Innovations for Civil Registration and Vital Statistics
in Asia and the Pacific Background
Every child is born with a name and an
identity, yet 230 million children under
the age of 5 remain unregistered. The
majority of these children live in Asia and
the Pacific. Without birth registration,
children may face exclusion from essential
services such as healthcare, education,
social services and protection. An
effective Civil Registration and Vital
Statistics (CRVS) system helps us secure a
person’s legal identity, tracks the major
events of an individual’s life such as; birth,
adoption, marriage, divorce, death, and
cause of death, and is essential for
planning, measuring and monitoring
progress of development. Civil
registration can also be a means of
empowerment and strongly linked with
equity and inclusive development.
Information and
Communication Technology
for CRVS
In the past few years, several initiatives
have been underway to harness the
potential of Information and
Communication Technology (ICT) to
strengthen CRVS. Success has varied;
however, a wealth of lessons learned and
knowledge is available to lead the way
forward in modernizing CRVS and
developing well-functioning systems.
Currently, there is a limited use of data
standards and open source technology in
CRVS. Beyond the paper-based systems,
many of the existing stand-alone
proprietary electronic systems were not
designed with interoperability or
integration in mind and cannot leverage
the power of web-based and mobile
platforms easily. Aside from the technical
possibilities, the use of standards and
open source technology can be a driving
force in fostering the political dialogues
that are necessary to implement
organizational changes needed for
integration of CRVS systems and data
sharing across ministries and specialized
systems and solutions.
The Government of Armenia believes in the
importance of better access to complete and accurate
civil and vital records. The Ministries of Health and
Justice and the National Statistical Service joined efforts
to improve demographic and health statistics.
Coordinated and synergetic efforts of the three
government institutions helped significantly reform the
system of civil registration and vital records, the health
information system and natural movement statistics. To
improve the quality of cause-of-death registration,
death certification training (for which a WHO online tool
is available) was conducted, ensuring that detailed
causes are captured by using the WHO’s International
Classification of Diseases coding to at least 3 digits. In
addition, a full assessment of the vital registration
system, including the quality of available hardware and
software, esnures full, effective coverage of birth and
death reporting.
Why is it innovative? • Realistic assessment of sectoral performance, services and
investments;
• More accountability;
• Evidence-based, sound and efficient decision-making conforms
with established international standards and modern trends;
• Regular collection, tabulation and publishing of current data
both at national and provincial levels;
• The following measures were undertaken to improve the
quality of health statistics, civil and vital records and natural
movements registration:
� A package of amendments was introduced to the law on
Civil Registration and Vital Records to ensure
completeness of birth, marriage and death registrations;
� Medical forms for birth and death registrations were
reviewed;
� Health system performance assessment and projections
were performed to assess the public health status and its
linkages to various determinants;
� Health statistics and key healthcare indicators are now
routinely collected, analyzed and disseminated.
• Future plans include:
� Design of a new policy and strategy for health information,
a new model and infrastructure for national and regional
information systems and creation of a single national
electronic data system;
� Establishment of a single national common electronic
system for civil registration and vital records;
� Modernisation of functions for capturing and processing
data on natural movements.
Armenia
Improvements to demographic
and health statistics
Bangladesh
Child Incentive Card (KIA)
The Birth Registration Information System (BRIS) was developed
by the Government of Bangladesh with the support of UNICEF.
It employs a software program to computerize birth registration
data. Under the BRIS, birth information is securely stored on the
centralized database server as soon as a birth is registered
anywhere in the country. It thus increases the reliability of birth
registration as an instrument of protection and identity.
Why is it innovative?
• Designed so that it is inter-operable with
other databases and information systems of
the country;
• Periodically produces automated statistics
and identifies any duplicated areas;
• Increases transparency and reduces possible
adulteration of data at various reporting
stages;
• Aims to store all citizens’ birth records in a
central database, allowing any organization
to use this database to verify the person’s
existence;
• Potential to link the database to
immunization and education databases.
Cambodia
Implementing Web-
based CRVS Database
Why is it innovative?
• Ensures real-time access;
• Enable robust monitoring and evaluation;
• Regular data compilation and analysis/user
friendly reports;
• Reduce hand writing workload;
• Easy to print and sign on multiple birth
certificates;
• Able to retrieve existing clients’ information;
• Avoid duplication registration;
• Produce unique ID for birth registration;
• Use fingerprint scan for verification-marriage
and reports.
A collaborative effort introduced a web-based CRVS
database with the following features: data stored on a
cloud-based Amazon server, access restricted by
username and password, data encrypted before
transmission, and easy-to-use mechanisms to perform
services such as retrieving and searching client data as
well as printing certificates. This resulted in improved
client satisfaction, less waiting time, faster receipt of
certificates, and a more modern and secure system.
The Government of Surakarta with technical support from
UNICEF introduced the Child Incentive Card (KIA) in 2009.
KIA was developed as a form of direct benefit to the child
upon birth registration. It is popularly known as a
“discount card” through which participating partners –
usually commercial businesses – offer discounted
products and services. The KIA card currently has 45
participating partners, including those in the education,
health, sport, food, clothing and tourism sectors.
Indonesia
Child Incentive Card (KIA)
Why is it innovative?
• Provides an incentive for registering births;
• Reflects and encourages partnerships
between the public and private sectors;
• Aims to integrate KIA issuance into the
existing integrated birth registration system;
• Increases demand for birth registration,
while noting that the introduction of the KIA
does not replace the ‘protection’ principle of
having a birth certificate in the first place.
RealMe is an initiative by the New Zealand Government which uses
civil registration data to allow citizens to get a verified online
identity. RealMe is a secure, consent based way to access and share
personal information online. With a RealMe verified account a
customer can prove who they are for government and private
organizations offering online services. This results in less work for
the civil registrar as they no longer need to issue as many
certificates and it makes it easier for customers who can complete
transactions online. As more services come on board with RealMe,
multiple government interactions can be achieved through one
digital channel and customers’ needs will be more easily met as
important life events occur. This may include the ability to
registering a birth, getting a passport, enrolling for health services
and being issued a tax number all at the same time!
New Zealand
RealMe
The Health Equity Monitoring System (HEMS) was
developed by the Iranian Ministry of Health and Medical
Education to reveal social determinants of health and
reduce inequities or deprivations. HEMS consists of 52
health equity indicators in one of five domains: health and
vital statistics, physical environment and infrastructure,
social and human development, economic development,
and governance. In monitoring the indicators, the system
allows the Ministry to analyze health data disaggregated
by socio-economic factors.
Iran
Health Equity Monitoring
System (HEMS)
Why is it innovative?
• The civil registration process becomes a tool
to access a range of online services;
• A secure, consent-based way to access and
share personal information online;
• Multiple government interactions can be
achieved through one online transaction;
• Customers’ needs easily met as important life
events occur – such as birth, education,
migration, health, financial planning and
taxes, retirement and death., death.
Why is it innovative? • Takes an inter-sectoral approach to reducing
health inequities;
• Measures 52 different indicators from various
domains at the district level – reaching
approximately 400 districts;
• Verified by data from the Iran Census 2011;
• Underlying data collection process composed of
• Produces data based on socio-economic deciles
and other variables such as level of education,
occupation, and geographical zones.
The National Database and Registration
Authority (NADRA) and Provincial
Governments in collaboration with Plan
International, WHO and Mobilink (Pakistan’s
largest cellular network) are developing a
scalable and sustainable model for Digital
Birth Registration (DBR) and CRVS
strengthening. Currently in the Analysis Phase,
the DBR programme aims to increase the birth
registration rates in the target regions and
prove a model for scalable and sustainable
CRVS strengthening across Pakistan.
Funded by Telenor Pakistan and implemented by UNICEF in
partnership with local government departments and the
National Database Registration Authority, this pilot project aims
to simplify and increase the effectiveness of the birth
registration process using cellular technology. The pilot is
currently being implemented in two districts; it is intended to
establish a working model and any customized solutions will be
detailed in the resulting national scale-up plan.
Pakistan
Digital Birth Registration and
CRVS Strengthening
Pakistan
Using Cellular Technology
for Augmenting Birth
Registration Rates
Why is it innovative? • CRVS analysis methodology used to identify scalable and sustainable
solutions (complimenting the CRVS Comprehensive Assessment);
• Use of Lady Health Workers (LHWs) as informants of birth through a
mobile phone application
• Secure transmission of birth data to the NADRA database in real time;
• Issuance of birth certificate at the local level (Union Councils);
• Elimination of additional and hidden expenses of travel for parents;
• Data is secure and kept confidential;
• Opportunity for public-private partnerships with mobile data
providers;
• SMS informs parents and LHWs that the birth certificate is ready to be
collected;
• Integration with health systems e.g. periodic immunization SMS.
Why is it innovative? • Reflects partnership between Telenor Pakistan
and UNICEF Pakistan;
• Proactive approach will entail activating
community-based gate keepers to reach out to
unregistered children;
• Entails a customized SMS-based application to
allow authorized community-based hot-spots to
register births in their population;
• Focuses on demand creation, improved citizen
interactions through process optimization, and
better planning and management of data.
PhilCRIS
The Philippine Civil Registration System (PhilCRIS) was
developed by the Philippine Statistics Authority for free
use by local civil registrars, hospital, churches, and other
end-users. PhilCRIS software allows easy encoding of
relevant information from civil registry documents, stores
vital data, queries and retrieves encoded records, enables
printing and issuance of certified copies of encoded civil
registry documents, and facilitates data management and
maintenance of local civil registry databases. It also allows
online checking of updates, as well as automatic
transmittal of civil registry files from local offices to the
central office.
Philippines
KE Vitalware is a comprehensive vital records
management system that securely manages the records
and business operations of Vital Records Offices and
Registries of Birth, Deaths, and Marriages. Vitalware
systems are installed in seven countries, including in the
U.S., Canada, Australia, and New Zealand. As one
important example, KE Software was chosen by Samoan
Justice Department to customize and implement the
system to suit their requirements. Nearly 200,000 records
have been captured onto the system, which is accessed by
9 concurrent users.
Why is it innovative?
• Enhanced with security features reduce the risk of
fraudulent access
• Secure system ensures all and only actual events are
recorded, and verifies certificate details after
issuance;
• Provides the flexibility and ease of use necessary for
day-to-day management of vital statistic information;
• Flexibility and speed also enables statistics offices to
develop new business services that quickly recoup
their costs – in fact, users have typically experienced
full cost recovery for their installations within two
years due to greater efficiencies;
• Provides staff with instant responses to almost all
queries.
Samoa and KE Software’s
VitalWare
Why is it innovative? • Provides village officials with an information
system to record and manage demographic
and biographic information about residents by
household;
• Encourages village officials to visit households
and interview individuals about possible
occurrence of births, deaths, and marriages;
• Provides a basis for village officials to actively
monitor pregnancies, and maternal and
neonatal deaths.
is it innovative?
Why is it innovative? • Easier data entry for certificates of live births,
marriages, and deaths
• Support data entry for attachments, such as for
Muslims and indigenous peoples;
• Automatically codes statistical items at the bottom of
new forms while entering corresponding data items;
• Has simplified backup and restore procedures;
• Facilitates data management and maintenance of
Local Civil Registry Offices.
BCRS
The Barangay (Village) Civil Registration System, or BCRS, is a
strategy to facilitate timely registration of vital events at the
community level. It empowers village officials to assist local civil
registrars in civil registration work. It is a systematic process of
reporting and monitoring vital events, particularly birth,
marriages and deaths, down to the village level.
Informed by a comprehensive literature review on the
information systems in place for civil registration in
developing countries, this research proposes the
development of two separate databases loosely
integrated for an optimal CRVS system. It recommends
that the two databases – one for birth/death and one for
marriage/migration – are managed by different
departments and each department adminsters its
respective databsae, while a common interface grants
universal access. The software is a noncommercial open
source software package, adaptable to future civil
registration needs.
Why is it innovative? • Managing the separate databases for birth/death
and marriage/migration spreads out the
responsibility while solidifying a sense of ownership
in the respective departments;
• Integration between the databases magnifies the
links between the two systems;
• Open source package is accessible to all;
• Provides mechanisms for notification of registrations
for births/deaths using mobile technologies,
generation of legal documents and vital statistics,
and integration with the Health Information System
already in place.
Sri Lanka
Use of E-health and M-
health innovations to
strengthen CRVS
Thailand
Innovative use of data linkages
between National Birth/Death
Registration and the National
AIDS Program
Thailand addressed issues of weak coverage and the
quality of Cause of Death (COD) reporting by combining
data sets related to Civil Registration and HIV
prevalence. Forming these linkages helped to provide
insights on the impact of the HIV ART program and
strengthen overall HIV program monitoring.
Why is it innovative?
• The techniques used to link birth/death registration to
National Aids program monitoring can be scaled,
replicated to other disease programs as well as
transported to other countries;
• Satellite district offices send data to central Ministry
of Interior, which transmits the information via an
encrypted message to the National AIDS Program
database;
• Connects mortality and morbidity data for improved
health monitoring and planning;
• Security protection for linking the two databases.
The WHO Open Smart Register Platform (OpenSRP) is a
mobile application that bridges health information
systems used by frontline health workers and CRVS
systems. Health providers interact with the OpenSRP app
on their mobile handsets; the application provides generic
birth and death registration tools. All data entry is
performed using the app, which can run on any Android
device. It strives to strengthen the ability of the skilled
health worker to more effectively deliver and account for
their health services to rural populations.
Why is it innovative? • Among the first tool to integrate CRVS systems with
external integrated platforms;
• Provides a single application for integrating
previously discrete, proven innovations including a
client register, online forms, scheduling tools,
multimedia, and automated reporting;
• Enables the use of legacy digital CRVS tools that may
already exist in the country of operation;
• Free, unrestricted open-source application;
• Mixes mobile technology, information system, and
support materials.
WHO and
Smart Registry
OpenSRP
Hawaii’s web-based Electronic Death Registration System
(EDRS) is linked to the Electronic Laboratory Reporting
System (ELRS) that enables the interoperability between
two different information and communication technology
(ICT) systems and software applications to communicate,
exchange data, and use the information in real time to
improve cause of death reporting in the civil registration
system and track influenza deaths for public health
purposes. Open-source standard messaging languages
(HL7/XML) and international data standards are used to
communicate and exchange data between the two ICT
systems. The linkage is a powerful tool to improve cause
of death reporting of influenza by confirming subtype
(e.g., H1N1) and differentiating seasonal flu from new
strains and as a disaster preparedness informational tool
in case of disease outbreak or pandemic. The linkage has
wider application to all causes of death that can be
confirmed with laboratory results.
Why is it innovative? • Public health disaster preparedness information tool
for disease outbreak and pandemics;
• Improves cause of death reporting with laboratory
confirmation (e.g., H1N1);
• Uses open-source standard messaging languages;
• Uses international data standards and definitions;
• Interoperability of EDRS with other ICT systems
• Automates identification of all deaths due to
influenza;
• Automates daily email notification of influenza
deaths by age and geographic area.
United States
EDRS and Influenza Cause of
Death Reporting in Hawaii
Vanuatu resulted in an increase of birth registration
of children under 5 from 40% in January 2013 to
52% at the end of 2013 by introducing decentralized
services and a nationally-led data management
system. Specifically, the Office of the Civil Registrar,
under the Ministry of Home Affairs, developed a
low-cost, open-source electronic data base system
linked to remote outer islands which ensures the
transfer of timely, accurate and secure data. The
expanded and decentralized approach addresses
the unique challenges of civil registration in
Vanuatu, which comprises 88 islands – 65 of them
inhabited – spread over more than 700,000 square
kilometers of ocean.
Why is it innovative? • Volunteerism – The database was developed by a
consulting volunteer together with Government partners
and in consultation with UNICEF. The value of
volunteerism is particularly relevant in Vanutu where the
Civil Registration Office obtains only 0.8% of the annual
budget allocated to the Ministry of Internal Affairs;
• Non-commercial – The software developed is a
noncommercial open source software package, adaptable
to future civil registration needs and those of other
Ministries and Government Departments in Vanuatu. It is
a fully flexible home-grown system, source-codes are
owned and it is under full control of the Civil Registry
Office;
• Overcoming unique geographic challenges – The database
has allowed for successful decentralization of the Civil
Registration Office with successful roll out of the database
to the education and health sectors. The system is
allowing for quick transfer of data in hardest-to-reach
locations in Vanuatu;
• Skills transfer – The initiative has had a solid and strong
focus on capacity building and sustainability from the
outset. The initiative continues to raise in-house capacity;
• Raising the profile of civil registration - The availability of
timely and reliable data has generated demand amongst
Government departments and recognition of the value of
civil registration core functions in informing national
planning. An increasing number of government
departments including the Prime Minister’s Office are
requesting access to data for use in planning;
• Appealing to the public - Providing the service directly to
parents and children in schools and hospitals has
increased public interest and demand. Introduction of a
photograph of the newborn baby and mother on the birth
certificate has generated great public interest in birth
registration.
Vanuatu
People-led Solutions
Nationally led Data
Management System
Title
Photo credits
Cover: UNICEF/
Page 2: Ponoma City Hospital
Page 3: UNICEF/ Shehzad Noorani
Page 4: Plan / Diosdado Capili
Page 5: C/o RealMe
Page 6: UNICEF / Giacomo Pirozzi
Page 9: c/o Smart Registry
Page 10: Samsung.com